The Relationship between Burnout and Wellbeing Using Social Support, Organizational Justice, and Lifelong Learning in Healthcare Specialists from Romania.

Background and objectives: The goal of this study was to evaluate the levels of organizational justice, social support, wellbeing, and lifelong learning associated with the level of burnout experienced by medical and non-medical staff from public and private medical units. Materials and Methods: A cross-sectional study was conducted on a sample of 497 healthcare professionals: 367 medical personnel (Mage = 43.75 ± 0.50), including 216 nurses, 97 physicians, and 54 respondents with other medical specialities such as biologists, psychologists, physical therapists, pharmacists, etc., and 130 non-medical staff respondents (Mage = 45.63 ± 0.80), including administrative personnel. The Maslach Burnout Inventory, the ECO System, the Multidimensional Scale of Perceived Social Support, the WHO Wellbeing Index, and the revised Jefferson Scale of Physician's Lifelong Learning were used. Results: Burnout was measured in terms of emotional exhaustion, depersonalization, and personal accomplishment. Medical personnel registered higher values of personal accomplishment (38.66 ± 0.39 vs. 35.87 ± 0.69), while non-medical personnel registered higher values of depersonalization (6.59 ± 0.52 vs. 4.43 ± 0.26) and emotional exhaustion (27.33 ± 1.24 vs. 19.67 ± 0.71). In terms of organizational justice, higher scores were observed for medical staff, while non-medical staff recorded lower values (24.28 ± 0.24 vs. 22.14 ± 0.38). For wellbeing, higher scores were also registered for medical staff (11.95 ± 0.21 vs. 10.33 ± 0.37). Conclusions: For lifelong learning and social support, no statistically significant differences were found. In the case of the proposed parallel moderated mediation model, the moderated mediation effects of organizational justice, lifelong learning, and burnout on the relationship between social support and wellbeing were valid for every dimension of burnout (emotional exhaustion, depersonalization, and personal accomplishment), but lifelong learning was not found to be a viable mediating variable, even if high levels of social support correspond to high levels of lifelong learning and wellbeing.

Burnout, Organizational Justice, Workload, and Emotional Regulation among Medical and Non-Medical Personnel Working in Romanian Healthcare Units.

BACKGROUND AND OBJECTIVES: The goal of this study was to evaluate the levels of organizational justice, emotional regulation, and workload associated with the level of burnout experienced in medical and non-medical staff from public and private medical units. MATERIALS AND METHODS: A cross-sectional study was conducted on a sample of 230 healthcare professionals, including 139 medical personnel and 91 non-medical staff respondents. The collected socio-demographic and organizational data and psychological tools were the Maslach Burnout Inventory (MBI HSS), the ECO System, and the emotional regulation questionnaire (ERQ). RESULTS: For medical staff, burnout was measured in terms of emotional exhaustion (M = 27.05 ± 12.34), depersonalization (M = 8.26 ± 3.95), and personal accomplishment (M = 47.35 ± 6.78). The scores for non-medical staff were emotional exhaustion (M = 35.84 ± 14.71), depersonalization (M = 11.79 ± 6.30), and personal accomplishment (M = 44 ± 7.37). In terms of workload, higher scores were observed for non-medical staff (M = 25.43 ± 7.87), while medical staff recorded lower values (M = 20.35 ± 7.65). The scores for the cognitive reappraisal dimension were as follows: medical personnel (M = 32.02 ± 5.37) and non-medical staff (M = 31.67 ± 6.19). In terms of the expressive suppression dimension, medical staff registered at M = 17.99 ± 5.61, and non-medical staff registered at M = 17.19 ± 5.53. For organizational justice, higher scores were registered for medical staff (M = 25.87 ± 6.02) and lower scores for non-medical staff (M = 21.34 ± 5.72). CONCLUSIONS: Medical staff felt a higher sense of organizational justice than non-medical staff, as is also evidenced by the level of the workload dimension, which registers higher values for non-medical personnel. In the case of burnout, higher levels of emotional exhaustion and depersonalization dimensions were also revealed for non-medical staff and, in the case of the professional fulfillment dimension, higher scores were registered for medical staff.

Exploring the Importance of Gender, Family Affluence, Parenting Style and Loneliness in Cyberbullying Victimization and Aggression among Romanian Adolescents.

The increasing phenomenon of cyberbullying among adolescents needs parental, educational, and social intervention. The study aimed to identify the prevalence of cyberbullying among Romanian adolescents and the importance of gender, family-related factors, self-esteem, and parental styles in both victims and perpetrators. A total of 835 adolescents aged 10-19 years were included in the research. An online questionnaire was specially constructed for this research, gathering socio-demographic and family-related data along with information about cyberbullying as a victim, aggressor, or bystander, and strategies used in order to deal with it. Four psychological scales were used to evaluate self-esteem, loneliness, cybervictimization/cyberaggression, and parental style. (3) Results showed that the most common age for a personal smartphone is M = 10.24 ± 2.43. The main reasons why students use these networks are primarily chatting and fun and less for academic tasks. During the week, adolescents spend 5.53 ± 2.75 h on social media, while during weekends, the duration of smartphone usage almost doubles. Girls are the most common victims of cyberbullying, and less than three-quarters of students believe that aggressors can be both girls and boys, and only a quarter of them have reported an incident. Family affluence, the relationship with parents and classmates, the presence of loneliness and sociodemographic factors were found to be in a strong relationship with the presence of aggression and/or victimization among adolescents. Cyberaggression was found to be positively correlated with the aggressive parental style and negatively correlated with the compassionate and avoidant parental styles. Results are crucial for identifying cyberbullying actors and preventing the negative effects of cyberbullying on psychological, social, and academic life for students, parents, and teachers.

Symptoms of Burnout Syndrome among Physicians during the Outbreak of COVID-19 Pandemic-A Systematic Literature Review.

Background: Studies in the recent decades show that the medical profession has a high risk to develop burnout due to constant exposure to mental and physical suffering or death. The pandemic period induced additional stress for healthcare professionals due to the likelihood of a high rate of infection, long working shifts, using protective equipment, staying away from family, implementing new medical procedures. The present study is focusing on assessing the prevalence of burnout among physicians working in the healthcare system during the COVID-19 pandemic, and discovering the main factors associated with burnout syndrome among the population of physicians. Material and methods: A systematic review was conducted by searching PubMed, Wiley, and Google Scholar in November 2021. A total of 35 studies were eligible for the evaluation. Results: The samples ranged from 39 to 3071 physicians, and the overall burnout ranged from 14.7% to 90.4%. Sociodemographic characteristics associated with a high prevalence of burnout were the female gender, less experienced, not having children, and single marital status, associated with high levels of anxiety, depression, and stress in the female gender. The highest level of burnout among all the studies was 90.4% on a sample of physicians from the Republic of Korea, 80.2% among psychiatrists in Saudi Arabia, followed by a study in Ireland with a 77% level of burnout among senior and specialist physicians, and 74.7% prevalence of burnout for emergency physicians in USA. Conclusions: During the pandemic, the factors that contribute to burnout are the lack of personal protective equipment and the violence of issues related to organizational health; the high prevalence of burnout symptoms is associated with anxiety, depression, and stress.

Body-Esteem, Self-Esteem and Loneliness among Social Media Young Users.

The use of social networking sites for socializing, having fun, solving academic tasks or even getting counselling for health-related problems is now inevitable. METHODS: A total of 427 medical students, who are users of social media sites, were included in the research. Data about socio-demographic, anthropometric, and self-rated items regarding satisfaction with physical and mental health were collected. Three psychological tools were also used to measure self-esteem (Rosenberg Self-Esteem Scale), body-esteem (Body Esteem Scale for Adolescents and Adults) and loneliness (UCLA Loneliness Scale). Collected data were analyzed using SPSS version 23. RESULTS: Students use these networks for socialization (49.0%), entertainment (31.1%) and academic tasks (19.9%), spending 3.38 ± 0.80 h per day on SNSs. Less than half of them (47.5%) compared themselves to other SNS profiles. The use of Snapchat was found to be strongly positively correlated with self-esteem, and weight status was negatively correlated with the use of TikTok. More than three-quarters declared that they exercised to lose weight or to prevent weight gain. Participants were found to have a high level of body esteem. Almost half of the students proved to have a moderate to a high level of loneliness. Age and gender were found to be important: the younger the user, the higher the scores for loneliness and feeling depressed, and the greater the number of hours on SNSs. The total score for self-esteem was significantly higher in men than in women, and male students appreciated themselves as being in a better state of mental health than women. CONCLUSIONS: The results prove a relationship between the use of SNSs and the presence of loneliness, self-esteem and body-esteem, with gender differences. However, the use of SNSs should not be neglected in clinical settings, and are a good means of reaching patients and providing medical and psychological intervention.

Socio-Demographic, Professional and Institutional Characteristics That Make Romanian Doctors More Prone to Malpractice Complaints.

Background and objectives: Medical malpractice is a phenomenon that shadows current medical practice, the number of complaints following an upward trend worldwide. The background for complaints is related both to the doctor and medical practice in general, as well as to the patient. The aim of this study was to identify a profile of the Romanian doctors who are more prone to receiving complaints, by analyzing the socio-demographic, professional and institutional characteristics. Materials and Methods: We conducted a quantitative, prospective research, the data being collected using a newly developed questionnaire. Data analysis was performed with the IBM Statistical Package for Social Sciences (SPSS, version 24). We used counts, percentages, means and standard deviation, and comparative and correlational analyses. A logistic regression model was applied to select a statistically best-fit model to identify independent predictors for receiving complaints; a Hosmer-Lemeshow test was used to check the performance of the prediction model. Results: The study group consisted of 1684 doctors, of which 16.1% had been involved in a malpractice complaint. Results showed that men, senior doctors from surgical specialties who perform a greater number of on-call shifts, those who work in regional or county hospitals, those who have greater fear of receiving complaints and those whose life partner is a doctor with the same specialty are more prone to receiving complaints. Conclusions: The profile identified by the present research underlines the main characteristics that could be targeted with specific measures in order to prevent the ongoing increase of malpractice complaints in Romania.

Assessing the Opinion of Mothers about School-Based Sexual Education in Romania, the Country with the Highest Rate of Teenage Pregnancy in Europe.

Background and Objectives: Without mandatory school-based education, Romania is a leading European country in teen pregnancy. This survey aimed at assessing the level of knowledge and the opinions about sexual education and sexual-related issues among mothers of female teenagers aged 13-18 years old. Material and Methods: The survey was conducted between 2015 and 2017 and had four parts, collecting data about sociodemographic variables, the level of knowledge about sexuality, sexually transmitted diseases, and contraception. The respondents were mothers of female teenagers hospitalized in a tertiary pediatric clinic. Data were analyzed using IBM Statistical Package for Social Sciences (SPSS) Statistics for Windows, version 25 (Inc., Chicago, IL, USA). Results: One hundred and thirty-five mothers (42.46 ± 6.81 years old) were included in the research. Most of them were from rural areas, had graduated secondary school, were Christian-orthodox, married, and with a stable job. More than half of the mothers (61.42%) declared that they personally knew adolescents that were already mothers. In great proportion, mothers proved good knowledge about sexual education, contraception, and STDs. They considered that the minimum age for becoming married, in general, is about M = 18.62 ± 2.09 years old but in the case of their daughters, mothers appreciated that the best age would be 23.56 ± 9.37. Mothers considered that they had good communication with their daughters (M = 4.28 ± 0.99) and two-thirds sustained that they had discussed with them about sexual activity, pregnancy, sexually transmitted diseases, and contraception. In case of unwanted pregnancy of their daughters, one-third of the mothers (38.50%) would advise their girls to continue the pregnancy and 7.40% mentioned the termination of pregnancy. Two-thirds of them (74.10%) agreed to school-based sexual education. In the order of preferred sources for sexual education, mothers mentioned parents (85.90%), teachers (33.30%), and family doctors (24.40%). Comparative results regarding their own sex life and that of their daughters are presented. Conclusions: School-based programs should meet parental beliefs about sexuality and sexual education. School, as a creator of values and models, should find the golden ratio to better shape the personal, familial, and social needs for the healthy sexual behavior of the new generation.

Gender Differences in Healthy Lifestyle, Body Consciousness, and the Use of Social Networks among Medical Students.

Background and Objectives: The goal of this survey was to identify the relationship between the level of satisfaction with body image, perceived health, and the usage of social media among freshmen medical university students. The influence of social media and peers was also related to body image. Materials and Methods: An online survey was distributed among freshmen healthcare students. The questionnaire collected sociodemographic, anthropometric data, and information about students' perception about healthy lifestyle using open-ended questions, as well as their opinion about the importance of perfect body image and the level of satisfaction with their physical appearance. Questions focusing on the use of social media and the relationship with body image collected data on the use of social networks and how they affect students' opinion about their own body image. Psychometric data were also gathered using the Body Consciousness Scale. For the statistical analysis, QSR NUD*IST (Non-numerical Unstructured Data Indexing Searching and Theorizing) Vivo 12 was used for qualitative data and IBM Statistical Package for Social Sciences (SPSS) Statistics for Windows, version 23 (SPSS Inc., Chicago, IL, USA) was used for descriptive and comparative results. Results: In total, 77 students aged 20.09 ± 2.47 years, of which the majority were women (75.30%), were included in the survey. The use of social network was about 4.81 ± 3.60 h/day. Facebook was the most used social networking site (94.80%), followed by Instagram (92.20%), Snapchat (16.90%), WhatsApp (15.60%), and TikTok (10.40%). The most common reason for using these sites was socialization. We found that 64.90% of healthcare students were normal weight. The main barriers for having a healthy lifestyle, as they were perceived by students, were the busy schedule and the lack of time needed to prepare healthy meals, lack of motivation, and lack of money. Women scored higher for the Private Body Consciousness and Public Body Consciousness scales. The main aspects related to a healthy lifestyle referred to physical activity, consumption of fruit and vegetables, water consumption, and a good quality of sleep. Gender differences were discussed as well. Conclusions: The results illustrated the complexity of the relationship between social media and body image and the need to prevent body image concerns, especially in young women.

Impact of COVID-19 Pandemic on Academic Activity and Health Status among Romanian Medical Dentistry Students; A Cross-Sectional Study.

During the first year of the COVID-19 pandemic, dental faculties had to rethink their way of teaching and interacting with students and of delivering solid theoretical knowledge and practical skills to students. BACKGROUND: The purpose of the study was to assess dentistry students' opinions about the online activity, together with a self-evaluation of their mental and physical health, during the first wave of the pandemic. METHODS: A cross-sectional study was conducted using an online survey. Three hundred and three students, enrolled across all six years of study, were included in the research. Socio-demographic and academic data were collected, along with a self-evaluation of physical and mental status. Some items investigated students' opinions about distance learning and the impact of that online activity on their achievement. The answers were rated using a five-item Likert-like scale. Data were analyzed using SPSS (v.24). RESULTS: statistical analyses showed that more than 20% of the students strongly agreed with the statement that they felt more anxious and depressed during the first months of the pandemic, and more than 30% were totally satisfied with their relationships with their family members. One-fifth of the respondents declared that they were totally dissatisfied with the relationships with their colleagues and friends. Overall, 50.60% of the students attended the courses/labs in their entirety when they were connected online. Two-thirds of the respondents considered that their practical training was affected due to the online activity, and that not all of the subjects could be taught online. More than half of the respondents agreed that the most objective evaluation method is that of the multiple-choice exams administered at school, and considered that exclusively utilizing online assessments of students encourages unethical behaviors. Age, involvement in online activity, and active participation using video cameras were strongly correlated with satisfaction with academic results. CONCLUSIONS: The results of the present study showed that online activity was a good alternative for dentistry students during the pandemic restrictions. The positive aspects, together with the negative consequences, of distance learning should also be taken into consideration by university teachers and academic institutions to improve teaching experiences and to ensure a solid professional formation for dentistry students.

The Relationship between Fear of Infection and Insomnia among Dentists from Oradea Metropolitan Area during the Outbreak of Sars-CoV-2 Pandemic.

Various studies have shown the impact of COVID-19 pandemic on mental health, identifying that people with a strong fear of getting infected are more prone to become stressed, depressed, anxious and to experience sleeping disturbance. The present study focuses on the impact of fear of COVID-19 and its relationship with insomnia among dentists. 83 dentists from public and private clinics were included in the research. A questionnaire was especially constructed for this study, consisting of three parts: the first part gathered socio-demographic and medical data, and a succession of self-rated items collected opinions about lockdown and preventive behaviors; the second part evaluated the level of fear of infection with Coronavirus-19 using the Fear of Covid 19 Scale; the third part investigated the presence of insomnia using the Athens Insomnia Scale. Collected data were processed using SPSS (v. 25). The total scores for fear of COVID 19 and insomnia were assessed. A strong positive correlation was identified between the total score of AIS and the total score of FCV-19S. The fear of COVID-19 had a significant positive correlation with the practice of several preventive behaviors. Dentists with chronic diseases were found to be more prone to suffer from insomnia than healthy dentists. Significant differences between women and men in terms of night symptoms were discussed. The findings are useful for dentists and policy makers to evaluate the impact of fear of infection on mental health status.

Evaluating the Practice of Preventive Behaviors and the Fear of COVID-19 among Dentists in Oradea Metropolitan Area after the First Wave of Pandemic; a Cross-Sectional Study.

Dental clinics were suspected to be a hotspot for nosocomial transmission of COVID-19 due to the easy spread of the virus. The study investigated the preventive behaviors applied in dentistry settings and the level of fear of COVID-19 infection among dentists. A total of 83 respondents (34.94% male and 63.86% female) were included in the research. Sociodemographic data were collected, together with new institutional and personal rules regarding preventive behaviors. Fear of COVID-19 Scale was used to measure the fear of infection. Data was analyzed using SPSS (v.25, SPSS Inc., Chicago, IL, USA). During the first seven months of confinement, 3.9% of dentists were confirmed with COVID-19 and one fourth treated confirmed positive patients. A quarter of the doctors declared that they had periods when they lived away from home being afraid of transmitting the disease to their family members, and significant data were found in doctors being parents. The closure of dental offices had a negative impact on the financial situation of dentists, especially on those working in rural area offices. Many doctors encountered difficulties in purchasing protective suits and medical supplies, and more than half of the respondents (65.1%, N = 54) focused on the quality of protective suits when purchasing them. More than half of the dentists were trained how to use them. The score for fear of COVID 19 was similar to dentists from other countries. Respondents with chronic diseases were more prone to show higher level of anxiety when following the news and stories related to COVID-19 on TV, media, or social networks. One third of dentists mentioned that they had treated exclusively specific urgent dental problems since the onset of the pandemic and more than 13.3% declared that they refused to provide medical assistance to some specific pathologies because of the fear of infection. The results reflect new challenges and rules adopted by dentists in order to diminish the risk of infection and the impact of pandemic considering their psychological, familial, and financial context. Policymakers and professional associations around may benefit from these findings while formulating guidelines to support dentists during COVID-19 or any future pandemics.

How the SARS-CoV-2 Pandemic Period Influenced the Health Status and Determined Changes in Professional Practice among Obstetrics and Gynecology Doctors in Romania.

Background and Objectives: The beginning of the SARS-Cov-2 pandemic period has had a strong impact on patients' life, but also on doctors. The main goal of this research is to identify the difficulties related to the professional activity and personal life of obstetrics and gynecology doctors. Material and Methods: In total, 94 physicians from a single university center answered to an online questionnaire. Socio-demographic, health, family, and job-related data were collected. Data were processed using SPSS (v.25). Results: 7.4% of the doctors were confirmed infected with SARS-Cov-2 during the first 6 months of the pandemic, and 48.94% treated infected patients. Due to the large number of patients, 10.64% of the doctors have had no days-off during the last 6 months, and 22.34% of them have had new medical problems that led them to see a specialist. Seventeen to nineteen percent mentioned an increasing number of working hours and shifts per month due to the pandemic period, more than 10% used pills to cope with work-stress, and 25% of them had sleep disorders along with appetite loss. Extra-protection rules and negative consequences of wearing special equipment were identified: thermal discomfort that caused decreasing resistance and concentration during the surgery (52%), reduced mobility and accuracy of surgical or medical gestures (40%), and intraoperative visibility (47%). Doctors who were working with confirmed pregnant women preferred caesarean section. Conclusions: Working under the stress of an infection with SARS-Cov-2 is causing a lot of pressure and determines changes in personal, familial, social, and professional life. Understanding the challenges that ob-gyn doctors are facing will help institutions to better provide support.

Factors Associated with Acculturative Stress among International Medical Students.

There is an array of reasons why acculturation can be stressful, and acculturative stress can be triggered by a plethora of factors. The aim of the study was to identify factors associated with acculturative stress among international students enrolled in a public medical university from Romania. 265 students were included in the research. Sociodemographic, academic, and family data, comfortability with living in study city, satisfaction with administrative staff, colleagues, and professors and Acculturative Stress Scale for International Students were gathered. Data have been processed using SPSS Statistics v23.0.0 for MAC.OSX. Female students are more prone to experience homesickness and stress due to change compared to male students. International students with Romanian origins had lower scores on perceived hate and stress due to change/culture shock compared to those with no Romanian origins. Students with relatives or friends enrolled in the same university had significantly lower levels of acculturative stress, perceived discrimination, perceived hate/rejection, and general/nonspecific concerns. Age and year of study are associated with homesickness and stress due to change/culture shock. The existence of factors associated with acculturative stress demand institutional, social, and psychological support for international students.

Reasons for and Facilitating Factors of Medical Malpractice Complaints. What Can Be Done to Prevent Them?

Background and objectives. Medical malpractice is an increasing phenomenon all over the world, and Romania is not spared. This matter is of concern as it has a significant impact on the physicians and the patients involved, as well as on the health care system and society in general. The purpose of our study was to perform an insight analysis on the reasons for medical malpractice complaints as well as the factors that facilitate the complaints to identify specific ways to prevent them and, implicitly, to improve the medical practice. Materials and Methods. The authors conducted a retrospective study of the medical malpractice complaints registered in the period 2006-2019 at the Commission for monitoring and professional competence for malpractice cases in the region of Moldova, Romania, collecting data on both the patients and the medical professionals involved. Results. The authors analyzed 153 complaints directed against 205 medical professionals and identified 15 categories of reasons for complaints, the most significant being related to the occurrence of complications, and to the doctor-patient interaction (e.g., communication, behavior, informed consent). The most frequently reported medical specialties were obstetrics and gynecology, emergency medicine, general surgery, and orthopedics and traumatology. Emergency medicine was often involved in complaints suggesting an over utilization of this department in our country and the need for health policies, which could divert the large number of patients accessing emergency medicine towards primary care. Conclusions. Regarding the dysfunctions in the doctor-patient relationship frequently claimed by patients, the authors concluded that doctors need special undergraduate training and periodic updating during their practice for them to be able to adequately address the challenges of interacting with their patients.

Eating Disorders in Relationship with Dietary Habits among Pharmacy Students in Romania.

Changing dietary habits of university students is due to personal, social, educational or religious factors. The relationship between dietary habits and presence of eating disorders among university students is less known in Romania. Material and Methods: Ninety-one pharmacy students (91.21% women) were included in the research. Socio-demographic, anthropometric, medical, and psychological data were collected. Dietary self-declared habits were registered. The analysis of data was done using SPSS, v23. Results: A total of 69.2% of students had normal weight, 64.84% preferred to have lunch, and 23.08% eat during nights. The majority of subjects (95.6%), stated that they eat snacks daily. More than one-third of students keep diets to reduce their weight. Younger students tend to eat more main meals per week, snack more, and eat later after getting up in the morning. Subjects with high body dissatisfaction tended to have fewer main meals (r = -0.265, p = 0.011) and to skip breakfasts (-0.235, p = 0.025) and dinners (r = -0.303, p < 0.001). Pharmacy students that presented higher rate of emotional problems tend to sleep less and skip breakfast. Conclusions: Female pharmacy students had higher mean scores on all subscales than those found among Romanian women. A strong relationship between dietary habits and eating disorders was identified.

Depressed as Freshmen, Stressed as Seniors: The Relationship between Depression, Perceived Stress and Academic Results among Medical Students.

Research in the field has identified the presence of stress and depression among medical students. However, no other study has pointed out the differences between years of study. The objectives of the study are to identify the levels of stress and depression among medical students and to point out the relationship between these two variables. Methods: The cross-sectional study gathered data regarding socio-demographic characteristics, depression, self-identified psychological and physical symptoms during stressful periods and perceived stress among medical students in a university in Romania. Statistical analysis was performed using IBM SPSS Statistics v23. For comparative analysis the t-test for independent samples and one-way ANOVA was used and for correlational analysis, Pearson and Spearman correlations was used. Results: Freshmen are the most depressed and graduating students are the most stressed medical students. Statistical analysis reveals an average score of perceived stress (M = 17.31 ± 6.79) and mild-moderate depression (M = 10.11 ± 7.69). Women are more prone to symptoms of depression. Students enrolled in the third year of study are the least depressed and the least stressed. Perceived stress is significantly positive correlated with depression and negative in strong correlation with the number of course credits received. More than half of students experience an increased rate of anxiety and consumption of alcohol, coffee, sweets or cigarettes during stressful academic periods. Over 60% declare themselves satisfied with their academic results. Conclusions: Strategies to diminish the level of stress and depression among medical students are necessary. Psychological support and educational counseling should start from admission, since freshmen experience the highest rate of depression.

The utility of Leventhal's model in the analysis of the psycho-behavioral implications of familial cancer - a literature review.

INTRODUCTION: We aim to highlight the utility of this model in the analysis of the psycho-behavioral implications of family cancer, presenting the scientific literature that used Leventhal's model as the theoretical framework of approach. MATERIAL AND METHODS: A systematic search was performed in six databases (EBSCO, ScienceDirect, PubMed Central, ProQuest, Scopus, and Web of Science) with empirical studies published between 2006 and 2015 in English with regard to the Common Sense Model of Self-Regulation (CSMR) and familial/hereditary cancer. The key words used were: illness representations, common sense model, self regulatory model, familial/hereditary/genetic cancer, genetic cancer counseling. The selection of studies followed the PRISMA-P guidelines (Moher et al., 2009; Shamseer et al., 2015), which suggest a three-stage procedure. RESULTS: Individuals create their own cognitive and emotional representation of the disease when their health is threatened, being influenced by the presence of a family history of cancer, causing them to adopt or not a salutogenetic behavior. Disease representations, particularly the cognitive ones, can be predictors of responses to health threats that determine different health behaviors. Age, family history of cancer, and worrying about the disease are factors associated with undergoing screening. No consensus has been reached as to which factors act as predictors of compliance with cancer screening programs. CONCLUSIONS: This model can generate interventions that are conceptually clear as well as useful in regulating the individuals' behaviors by reducing the risk of developing the disease and by managing as favorably as possible health and/or disease.

Determinants of Hospital Pharmacists' Job Satisfaction in Romanian Hospitals.

Aim: The purpose of this study is to identify the level of job satisfaction among hospital pharmacists in Romania in relation to environmental, socio-demographic, and individual factors. Material and Methods: Seventy-eight hospital pharmacists were included in the research. The Job Satisfaction Scale was used to measure the level of satisfaction with their current jobs, and the TAS-20 was used to evaluate emotional experience and awareness. Additionally, 12 items were formulated in order to identify the reasons for dissatisfaction with jobs, such as budget, number of working hours, legislation, relationships with colleagues, hospital departments, or stakeholders. Data were analyzed using IBM SPSS Statistics version 23. Results: The analyses of the data revealed a low level of satisfaction regarding the pay-promotion subscale, a high level of satisfaction with the management-interpersonal relationship dimension, and a high level of satisfaction regarding the organization-communication subscale. Seventy-four percent of subjects are dissatisfied about the annual budget, and 86.3% are not at all satisfied with present legislation. Conclusions: These results are important for hospital pharmacists and hospital management in order to focus on health policies, management, and environmental issues, with the purpose of increasing the level of satisfaction among hospital pharmacists.

Cognitive-Behavioral Coping, Illness Perception, and Family Adaptability in Oncological Patients with a Family History of Cancer.

Aim. The study investigated the differences between patients with and without a family history of cancer regarding coping strategies, illness perception, and family adaptability to the disease. Material and Methods. A total of 124 patients diagnosed with cancer were included in the research (55 of them with a family history of cancer). The Cognitive Emotion Regulation Questionnaire, the Strategic Approach to Coping Scale, the Family Adaptability and Cohesion Scale, and the Illness Perception Questionnaire were applied. The data were processed using the SPSS 21 software. Results. Patients with previous records of cancer in the family get significantly higher scores for the illness coherence factor. Family satisfaction is significantly higher for patients with a genetic risk, compared to the one reported by patients who suffer from the disease but have no genetic risk. Cognitive-behavioral coping strategies and family cohesion are factors that correlate with an adaptive perception of the illness in the case of patients with a family history of cancer. Conclusion. Results are important for the construction of strategies used for patients with a family history of cancer.

Pregnancy during Adolescence and Associated Risks: An 8-Year Hospital-Based Cohort Study (2007-2014) in Romania, the Country with the Highest Rate of Teenage Pregnancy in Europe.

Aim. To determine pregnancy and delivery outcomes among teenagers. Materials and Methods. An 8-year retrospective comparative hospital-based cohort study is analysing singleton pregnancy comorbidities and delivery parameters of a teenage group under the age of 20 compared with a young adult group 20-24 years of age in a university hospital. Results. Teenage is a risk factor for preterm birth <37 weeks (1.21 [1.08-1.35]), foetal growth restriction (1.34 [1.21-1.48]), episiotomy (1.27 [1.21-1.34]), uterine revision (1.15 [1.06-1.25]), APGAR <7 at 1 min (2.42 [1.21-1.67]), cephalopelvic disproportion (1.26 [1.07-1.48]), and postpartum haemorrhage (1.42 [1.25-1.62]); however, caesarean delivery occurs less frequently in teenagers than in adults (0.75 [0.70-0.80]). The following comorbidities are risk factors for teenage pregnancy (risk ratio [CI 95%]): anaemia (1.13 [1.10-1.17]), low urinary tract infection (1.10 [1.03-1.18]), pediculosis (2.42 [1.90-3.00]), anogenital condyloma (1.50 [1.04-2.17]), and trichomoniasis (1.74 [1.12-2.68]). The risks for hepatitis B and hepatitis C, premature rupture of membranes, and placenta praevia were lower compared with those in the young adult group, respectively, 0.43 (0.26-0.71), 0.90 (0.85-0.96), and 0.29 (0.20-0.41), while the risk for gestational diabetes and preeclampsia were the same in both groups. Conclusion. Considering the high risks for teenage pregnancy, this information should be provided to pregnant adolescent women and their caregivers.